gms | German Medical Science

85. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

28.05. - 01.06.2014, Dortmund

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Preferential reinnervation of adductor muscles after inferior laryengeal nerve injuries – Its clinical importance in bilateral vocal cord paresis

Meeting Abstract

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  • corresponding author László Rovó - ENT Department, University of Szeged, Szeged, Hungary
  • Vera Matievics - ENT Dep., University of Szeged, Hungary, Szeged, Hungary
  • Dóra Pálinkó - ENT Dep., University of Szeged, Hungary, Szeged, Hungary
  • Balázs Sztanó - ENT Dep., University of Szeged, Hungary, Szeged, Hungary
  • Ádám Bach - ENT Dep., University of Szeged, Hungary, Szeged, Hungary
  • József Géza Kiss - ENT Dep., University of Szeged, Hungary, Szeged, Hungary

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 85. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Dortmund, 28.05.-01.06.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14hnod125

doi: 10.3205/14hnod125, urn:nbn:de:0183-14hnod1250

Veröffentlicht: 14. April 2014

© 2014 Rovó et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

Text

Introduction: Both experimental studies and clinical observations show residual adductor muscle activity occur very often after inferior laryngeal nerve injury. This is thought to be spontaneous regeneration of the nerve with a predominance of reinnervation of adductor muscles. This may account for the medial position of the paralyzed vocal cords, moreover a voluntary adduction of vocal cords in permanent paralyses. A glottis enlarging procedure which leaves intact those muscles may provide an improved airway with the possibility of active voicing.

Methods: The authors report on7 women and 3 men after thyroidectomy caused bilateral vocal cor paresis (BVCP) were treated by endoscopic arytenoid suture lateropexy. The objective and subjective airway and voice improvement, and laryngeal electromyography (LEMG) were assessed.

Results: This group of patients demonstrated an active voluntary adduction on the contralateral side of the glottis enlarging procedure (postop 1 week – 9 months, average: 4 months) Beside stable immediate significant airway improvement the voice parameters approximated to normal values, and voluntary muscle activities were detected by LEMG.

Conclusion: The results unambiguously prove the predominant adductor reinnervation after inferior laryngeal nerve injury in many cases. This might provide a reasonable solution of BVCP by an adequately chosen surgical method allowing a simple dynamic solution with good voice and breathing.

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